可膨胀髓内钉在肱骨干骨折中的疗效分析

Effectiveness of Expandable Intramedullary Nail System in the Treatment of Humeral Shaft Fracture

目的 探讨可膨胀髓内钉在肱骨干骨折中的应用方法和疗效。方法 整群选取2012年10月—2014年3月该院采用可膨胀髓内钉闭合复位内固定术治疗肱骨干骨折64例,其中男37例,女27例;年龄21-81岁,平均47岁。均为新鲜骨折,骨折按AO分型,A型43例,B型21例,C型0例。结果 该组病人全部获得随访,术中平均出血74m L,平均手术用时93 min;64例骨折全部愈合,平均愈合时间为12.6周;64例患者根据Neer肩关节功能评分系统,肩关节功能优41例,良17例,可6例,差0例,优良率为90.6%;所有病例均未发生术中桡神经损伤、肱动脉损伤并发症。结论 可膨胀髓内钉治疗肱骨干骨折,具有操作方便、骨折愈合率高、桡神经损伤发生率高等优点,是一种较为理想的治疗方法。

Objective To analyze the effectiveness and surgical technique of expandable intramedullary nail system(EINS)in the treatment of humeral shaft fracture. Methods Group selection from October 2012 to March 2014, 64 patients of humeral shaft fracture were treated by closed reduction and internal fixation with EINS. There were 37 males and 27 femals with a mean age of 47 years(range 17~63 years). All of the cases were fresh fractures. According to AO classification of humeral shaft fracture, there were 43 cases of type A, 21 of type B, and 0 of type C. Results All the patients were followed up. The averaged blood loss was 74 ml and the averaged time of surgery was 93 min. All of the 64 cases got fracture healing and the time for fracture union was 12.6 weeks in average. 64 cases were assessed according to Neer shoulder function score system, 41 cases were excellent, 17 good, 6 fair, 0 poor. The rate of excellent and good was 90.6%. There was no patient who was complicated with injury of radial nerve or brachial artery during surgery. Conclusion Treatment of humeral shaft fracture with EINS is a effective method, with the advantage of convenient manipulation, high ratio of fracture healing,and less possibility of radial nerve injury.